Abstract

Aim: During surgery for childhood neck masses, recognition of the association between the mass lesion, and neck vasculature and adjacent nerves, and preserving these structures is a prerequisite. In this study, we aimed to emphasize the role of magnetic resonance imaging for determining important anatomic benchmarks in the surgery of rare lateral neck masses of children.

Material and Method: Hospital records of all patients who had been operated for rare lateral neck masses, between June 2010 and June 2013 in our clinic were retrospectively evaluated. Results of radiological imaging, perioperatively encountered anatomical structures, and their histopathologic diagnoses were evaluated.

Results: Before excision of the cervical masses, ultrasonography (US), and magnetic resonance imaging (MRI) studies were performed in all four female and one male case whose ages ranged between 3 months, and 11 years. In one case additional computerized tomography (CT) scan was obtained. Relationships of the masses to a. carotis interna, v. jugularis interna and externa, cupulae pleura, m. trapezius, n. accessorius, n. hypoglossus, and/or m. omohyoideus were noted. Following histopathologic evaluation of the excised masses diagnoses of cervical lipoma (1), cervical neuroblastoma (1), recurrent branchial cyst (2), and cervical epidermoid cyst (1) were made.

Conclusion: The masses located in lateral cervical triangles may be in close relation with vital and important anatomic structures which may be easily injured during the excision of the mass. Before excision of the mass, delineating the anatomic relationships of the mass with its neighboring tissues, and exposing these anatomical structures are important in the prevention of the development of possible complications. MRI is a very helpful diagnostic adjunct to delineate these anatomic structures adjacent to the mass lesion.